26D2027892 CLIA NUMBER - CROSSROADS HOSPICE OF ST LOUIS, LLC

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Laboratory Demographics

CLIA Number: 26D2027892

Facility Name: CROSSROADS HOSPICE OF ST LOUIS, LLC

Facility Address:
15450 SOUTH OUTER FORTY DRIVE, SUITE 100
CHESTERFIELD, MO
ZIP 63017
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Facility Phone Number: 314 801-6960

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1669612511

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	26D2027892
LAB Type	Hospice
Facility Name	CROSSROADS HOSPICE OF ST LOUIS, LLC
Street	15450 SOUTH OUTER FORTY DRIVE, SUITE 100
City	CHESTERFIELD
State	MO
ZIP	63017
Phone	314 801-6960
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024